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<br /> 813-78U-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Building Department
<br /> Date Recaived �%�r� phone Contact for Permitting 8 �� ��a _- o�a 5.
<br /> owner's.Name, . � C.G�G��\ �a�C�`L'��ti u� Owner Phone Number 9 6�3 —58� ��3 d��f
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<br /> O,wne�;s�Addres's;�, D oc��J (�,C�SS i� �' l� S Owner Phone Number
<br /> Fee Slmple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address �
<br /> JOBADDRESS•. Dy3� ��V���� "�' �� ��` ��s � 1" ���� LOT# C�
<br /> SUBDIVISION�„ S��V'Q.r ��r KS v`�``�' 11' �PARCEL"ID# O�j� o� b-�`�U�a� � ������-�13 6
<br /> ", • � (OBTAINED FROM PROPERTYTAX NOTICE)
<br />' W.ORK,F?ROPOSED� NEW CONSTR ADD/ALT Q SIGN Q MOVE [� DEMOLISH
<br /> � " � INSTALL e REPAIR J
<br /> PROPOSED USE , Q SFR Q COMM Q OTiiER '
<br /> TYPE OF CONSTRUCTION Q^ BLOCK �� FRAME [� STEEL Q OTHER
<br /> DESCRIPTION,OF� .WORK; ��`����''� ��'�� �� '�� 1 � � ��� r`pW S e
<br /> BUILDING SIZE; ���� � ;SQ�F007'AGE ��� l HEIGHT a br5'� �
<br /> .,.-._._,..,-,._,,.:�.m-._..�.__.,�,-...... „
<br /> BUILDING, ,; $�:.;��'���,�.�:: :-... _ ......... . ,
<br /> "°. ���'� � `�
<br /> , f VALUATION�.OF-TOTAL:CONSTRUCTIO �
<br /> �'��•-`.' "''�.�.:� , _ ,.
<br /> .,�.:
<br /> Q ELECTRICAL' $ AMP SERVICE Q PROGR ENERGY Q WR.E.C.
<br /> 1 � ��( Sr� .
<br /> Q , PLUMBING $ `� `��� C�--`� � .�
<br /> ., � r ��r�/�s
<br /> Q MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � y����
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<br /> Q 'GAS Q ROOFING � SPECIALTY Q OTHER - '� ��
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
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<br /> BUILDER - COMPANY 1�-� ��`� GonS��'�'� `�c �Y�C,,
<br /> SIGNATURE Re�is�Reo Y/ N FEE CURRENT Y/N
<br /> Address �6 �3 SR ��E i �e . � �r��I��S�'�L. 33�4 � License# C�C. I S I 1—J.�71
<br /> ' � ��s-�- ��:sc�o �.��.c,�f:c.
<br /> ELECTRICIA COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N
<br /> Address Q • �-�S � � ��
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<br /> PLUMBER COMPANY '�
<br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N
<br /> Address y /tA Gl� 9� �h.�� S ��J / License# l.��C� � �J�
<br /> M�ECHANICA,L , COMPANY ���n `S '/�'� �
<br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N
<br /> Address Z�� (��' ,�� �`i .��Z� License# �7C, ���� Q �
<br /> ....v-i".." � I I.""'� �''��� G � ' • . ,
<br /> OTHER<:S,___; COMPANY
<br /> SIGNATURE;� _ REGISTER�D Y/ N FEE CURRENT Y/N
<br /> AdcJress �'�.I 3 St�5� ;r-(��((5 �Z 33'�J`-�( �`Ucense# ���J Z S��
<br /> RESIDENTlAL Attach.(2)Plot Plans;(2)sets of 8uilding Plans;(1)set of Energy Forms;R-O-W Permit for new construction,
<br /> -Minimum ten(10)working days after submittai date. Required onsite,Constri�ctibn Plans,Stormwater Plans w/Silt Fence lristalled,
<br /> Sanitary Facilitles&1 dumpster;.Site Work Perm(t for subdivlsionsAarge projects , •
<br /> COMMERCIAL Attach(3)sets of Building Plans;(1)set of Ene�gy Forms.R-O-W.Permit for new construbtion.
<br /> Minimum ten(10)working tlays after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facillties 8 1 dumpster.Sfte Work Permit for all new projects.All commercial requirements must meet compliance' �
<br /> SIGN PERMIT Attach(2)sets of Engineered Plans. � , , �
<br /> ""PROPERTY SURVEY'requlred for all NEW construction. . - '
<br /> Directlons: ' � ,
<br /> Fill out application completely.
<br /> Owner&Contractor sign back of application,notarized
<br /> ' If over$2500,a Notice of Commencement is required. (A/C upgrades over$5000)
<br /> '" Agent(for the contractor)or Poa e��of,�4ttomey,(for,theeqygner);would be someone with notarized letter from owner authorizing same
<br /> - . .•;.•�....�-.��.:.�; : �.,�••.:aa...c:r..:;,.,:�,:..:::,.
<br /> 'OVER THE COUNTER PERMI7TING "���(Front•of Application Onlj� � ,,; �;. •.•;. �,:�:,,� ,
<br /> Reroofs Sewers Service Upg�aiies , ��;A/Q;` Fences(PIoUSurvey/Footage) . , � . ' ' � - t,�
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<br /> Driveways-Not over Counter if an public roadways..needs ROYV , , • � ��7
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